bonus 6 Flashcards
While evaluating a patient with psoriasis vulgaris, the nurse practitioner expects to find:
Lichenification in the post-auricular region.
Maculopapular lesions over the upper thorax.
Scaling lesions within the nasolabial folds.
Well-demarcated plaques and coalescing papules on the knees correct
Well-demarcated plaques and coalescing papules on the knees correct
Mr. Woods is a 63-year-old man who presents for initial evaluation at your practice. He has a 45 pack-year smoking history and COPD that is currently being treated with daily oral theophylline and albuterol via MDI prn. He complains of shortness of breath and chronic cough with sputum production. He states, “I can barely walk to my car without getting out of breath.” Spirometric assessment reveals an FEV1 of 45% predicted and a FEV1:FVC of 62%. His health history reveals 3 exacerbations in the past year. The best course of action for Mr. Woods to minimize COPD exacerbation risk is to:
Continue on theophylline therapy.
Advise using albuterol on a set schedule rather than prn.
Switch to a long-acting beta2-agonist as needed for shortness of breath.
Add therapy with a long-acting muscarinic antagonist uses on a set schedule
Correct—Add therapy with a long-acting muscarinic antagonist uses on a set schedule
A 20-year-old male complains of being fatigued for the past week. The physical examination is significant for anterior and posterior cervical lymphadenopathy and right and left upper quadrant abdominal tenderness. A white blood cell differential is significant for lymphocytosis with reactive forms. Which of the following additional findings does the nurse practitioner anticipate?
Pharyngitis with exudate
Supraclavicular lymphadenopathy
Diffuse maculopapular rash
Marked sinus tenderness
Correct—Pharyngitis with exudate
Clinical evaluation of a 43-year-old man with a BMI=42 kg/m2 who presents with recurrent genital Candida albicans infection should include all of the following except:
Treatment with oral or topical antifungals.
Offering testing for HIV antibodies.
Avoidance of soap on the genitals.
Checking A1C
Correct—Avoidance of soap on the genitals.
The mechanism of action of saxagliptin includes:
Increase in hepatic glucose utilization.
Enhanced insulin release.
Facilitation of renal glucose excretion.
Enhancement of insulin receptor site activity
Correct—Enhanced insulin release )DPP-4)
The preferred therapeutic option to resolve the underlying pathology in Graves’ disease is:
Non-cardioselective beta blockade.
Surgical resection of hyperfunctioning nodule.
Radioactive ablation of overactive thyroid tissue.
Levothyroxine suppression therapy
Correct—Radioactive ablation of overactive thyroid tissue.
A 54-year-old man with COPD is experiencing an exacerbation characterized by increased cough and shortness of breath for the past 48 hours, as well as mild sore throat, clear nasal discharge and body aches. He is currently using a long-acting beta2-agonist and long-acting muscarinic antagonist. An appropriate treatment for this patient would include:
Oral mucolytic.
Oral antimicrobial.
Oral corticosteroid.
Oral bronchodilator
Correct—Oral corticosteroid
In initial prescription of levothyroxine therapy, which of the following statements is true?
TSH should be checked about 2 days after dose adjustment.
The anticipated thyroxine dose is usually calculated using an age- and weight-based formula.
TSH should be suppressed to undetectable measures when seeking therapeutic effect.
The therapeutic dose of thyroxine needed by the elderly is approximately the same as that needed by the younger adult and child.
Correct—The anticipated thyroxine dose is usually calculated using an age- and weight-based formula
A 52-year-old woman presents to your office as a new patient. She reports a long history of high blood pressure, and admits she does not regularly take her medication. Which of the following is an anticipated funduscopic finding?
Narrowing of arterioles
An increased cup:disk ratio
Macular degeneration
Cotton-wool spots
Correct—Narrowing of arterioles
Which of the following are potential candidates to receive the PCV13 pneumococcal vaccine? (YES or NO)
A 67-year-old man who received the PPSV23 vaccine 1 year ago– YES
A healthy 58- year-old woman who is receiving the seasonal influenza vaccine today– NO
A 48-year-old man who uses smokeless tobacco– NO
A 36-year-old woman with HIV infection who received the PPSV23 vaccine 3 years ago– YES
CORRECT
Which of the following is most consistent with the diagnosis of herpes zoster?
Papules in a dermatomal distribution
Low-grade fever and malaise prior to eruption
Presence of pustules and honey-crusted lesions
A 1–2-day prodrome of pain prior to lesions erupting
Correct—A 1–2-day prodrome of pain prior to lesions erupting
VESICLES NOT PAPULES
Which of the following is most consistent with the diagnosis of depression?
Recurrent diarrhea and cramping
Difficulty initiating sleep
Diminished cognitive ability
Consistent early morning wakening
Correct—Consistent early morning wakening
A 52-year-old man presents for evaluation of fatigue. His physical examination is significant only for intention tremor and asymptomatic pharyngeal redness. He reports a history of recurrent gastritis. Laboratory examination results are as follows: -Hb=14.3 g/dL (143 g/L) -Hct=48% (.48 proportion) -MCV=109 fL - HDL-C=58 mg/dL (1.5 mmol/L) -LDL-C=118 mg/dL (3.06 mmol/L) - Triglycerides=318 mg/dL (3.59 mmol/L) These findings are most consistent with:
Pernicious anemia.
Iron deficiency anemia.
Alcohol abuse.
Normal findings
Correct—Alcohol abuse
